Catching Babies for a Living

In 23 years as a physician, Dr. Becky Graham, O.B., has practiced in every setting – hospitalist, urban private practice and health care in rural settings. She’s endured the heartbreak of health system cuts and experienced the excitement of seeing generations of families come to her for care.

Those experiences have honed a fine sense of how to make a practice flourish and some keys to success that transcend strong marketing campaigns. Don’t misunderstand. Marketing is critical, but it’s only one spoke in the wheel of a strong, financially solvent practice.

Some of those spokes are deeply-rooted, timeless attributes, like putting patients first. That’s always been the cornerstone of Graham’s years in medicine. But there are other factors that physicians weighing private practice must consider. When joining a group practice, make sure the group is highly-respected and financially sound. That’s good sense from a marketing perspective.

“From a marketing point of view, nothing is as good as joining a practice with reputable physicians that will funnel you patients and where there are plenty of primary care physicians that will funnel you patients. If you have to depend entirely on marketing, I don’t know if there is a marketing practice that can overcome that.”

While practicing medicine in rural Kansas, Graham’s practice got a big bounce from a billboard, as well as social media. But a billboard in a highly-competitive market may not be worth the higher cost. Graham found success in rural Parsons and Fort Scott, Kan.

“All of it is word of mouth,” Graham said. “When I practiced in rural Kansas, I had a billboard and I got a lot of patients from the billboard.”

“In larger markets, outdoor can be expensive but was more affordable in rural areas. In Parsons, I couldn’t go anywhere without people knowing me, whether they’d been in my practice or not. “(They’d say,) ’Oh, you’re the lady on the billboard. You catch babies for a living.’ It was very effective.”

Look for free opportunities to market your practice. For small-town newspapers, especially in rural areas, a new physician in town is big news. And the space you’ll get from a story and photo is comparable to a print display ad – all without costing a dime. Graham also had success via social media, particularly on Facebook.

Think generationally. Health care is similar to banking in that if possible, children are likely to go to the same physician or hospital as their parents and grandparents – if the physician stays long enough. Or sometimes, the situation is reversed. If a daughter or son like a physician, there’s a real possibility parents and grandparents will come to the practice as well. “It always went one way or the other,” Graham said. “Either the grandma would come and if she liked me then her daughter would come. If she liked me her daughter would come. Or, they would send the teenager in, and if the teen liked me the Mom would come. And if the Mom liked me, then Grandma would come. Yes, I had a lot of families.”

Community visibility counts. Graham also attracted patients by virtue of her faith. As a church worship leader and being active in the Cursillo movement, the community came to know Graham beyond the office. Other civic activities – Rotary, Kiwanis, or volunteer efforts – can also make a difference. By her visibility in various church roles, Graham became “home folks” to the people in the community, a factor that can drive patient loyalty. “I had a lot of patients that came because they knew my faith,” Graham said. I think that’s true in a lot of places. They see a doctor in church, then they know who they are as a person.”

Beyond Facebook: Facebook pages and blogs can be effective, but many times, physicians are swamped with increased paperwork to maintain a blog. There are other technology tools that can boost a practice, like ZocDoc, which provides patients with periodic reminders of upcoming appointments. Graham saw a reduction in the number of no-shows in her practice.

Consider culture: In rural communities and in some immigrant communities, there is a closely-held belief that women should only be seen by female doctors. Graham recalled a Libyan patient who spread word among that community about her practice, attracting more patients. “A lot of times, ethnic or cultural factors would determine who came into my practice.”

And last a reminder: Don’t go it alone: Find good partners with good reputations and solid finances. Shrinking Medicaid and Medicare reimbursements – consider $17 for a wellness visit in rural Kansas – and (depending on the state) rising malpractice premiums – can make the cost of a solo practice, quite challenging.